Biocompatible PD fluids are cost-effective (in capitated systems…)

In Australia, where the cost of hospitalization is of concern to the National Healthcare System, one group of PD patients was given biocompatible PD fluid, while a control group received standard PD fluid. After 2 years, the more costly biocompatible fluid created significant cost savings due to reduced peritonitis and hospital stays.

Read the abstract » | (added 2015-04-10)

Tags:

Icodextrin reduces PD failure and boosts survival

In a prospective trial of 306 incident PD patients between 2007 and 2011, those who used icodextrin were significantly more likely to continue with PD and more likely to live longer than those who used standard PD fluid.

Read the abstract » | (added 2015-04-10)

Tags:

Biocompatible PD fluid reduces cell death due to inflammation

In time, the peritoneum (just one cell layer thick) can wear out when used for PD. A new study finds that peritoneal cells in petri dishes bathed in standard PD fluid were more likely to die due to inflammation caused by glucose. But, cells bathed in biocompatible fluids were protected from the damage. In humans, this means that the peritoneum may last longer.

Read the abstract » | (added 2015-04-10)

Tags:

Maximum ultrafiltration rate as a measure of optimal HD

Dialysis removes both wastes and water. Yet, while we have measures for waste removal, we have no marker for water—even though, in the short run, it is more important for patient health and well-being. Dr. Agar proposes a maximum ultrafiltration rate.

Read the abstract » | (added 2015-04-10)

Tags:

More reasons to use PD fluid with less sugar

Using a novel index created by dividing the glucose content of PD solution by body weight, this study looked at the impact of PD fluid sugar on hemoglobin A1c, fluid overload, and inflammation (measured by interleukin (IL) 6) in 43 people on PD. Higher sugar levels were linked with worse diabetes control, more fluid overload, and higher IL-6 levels.

Read the abstract » | (added 2015-03-11)

Tags:

On PD, less inflammation linked with longer survival

Among 87 people on PD, ages 30-85, who were followed for 30 months, the inflammation marker serum amyloid-A (SAA) was a significant independent predictor of mortality. When four markers of inflammation were analyzed together, SAA, age, and the presence of cerebrovascular insults were the strongest predictors.

Read the abstract » | (added 2015-03-11)

Tags:

To stop PD catheter migration: location, location, location

The “real estate” used for PD catheter placement matters in preventing catheter tip migration, a study finds. Compared to 98 people who received conventional left quadrant PD catheter placement, 139 whose catheters were placed in the right lower quadrant had significantly less catheter tip migration (19.3% vs. 3.6%; P<0.01) with similar inflow and outflow time, ultrafiltration volume, infection, hemorrhage, and obstruction rates.

Read the abstract » | (added 2015-03-11)

Tags:

Bioartificial kidney challenges

When Shuvo Roy is an author on a bioartificial kidney review paper, you know it is worth reading. Cell-based therapies are an approach to duplicate all of the functions of a healthy kidney, including hormone production. But, where the cells come from, organ scaffolding, and immune response remain challenges even in animals—let alone humans.

Read the abstract » | (added 2015-02-10)

Tags: Chronic kidney disease

FHN finding: Frequent and/or Nocturnal HD lowers blood pressure

In the Frequent Hemodialysis Network trials, those randomized to short daily HD had systolic BP an average of 7.7 points lower than those in the standard HD group. Diastolic BP came down an average of 3.9 points. Fewer BP meds were needed. Those who did nocturnal HD had systolic BP an average of 7.3 points lower, and diastolic an average of 4.2 points lower.

Read the abstract » | (added 2015-02-10)

Tags: Nocturnal Hemodialysis

PD training: How much is enough to reduce peritonitis risk?

In a group of 2,243 patients from Brazil, two thirds with less than 4 years of education, training time mattered. After nearly a year of follow up, those whose training was less than 1 hour per session were more likely to have peritonitis. And, those who had at least 15 hours of training had significantly less peritonitis than those who had less. Having a care partner or training multiple people did not affect the risk. But, training before the catheter was placed or at least 10 days after did help.

Read the abstract » | (added 2015-02-10)

Tags: